1) https://www.thediabetescouncil.

com/surprising-benefits-of-bitter-melon-for-diabetes/

Surprising Benefits of Bitter Melon

for Diabetes
Bitter melon is also known as karela, bitter gourd, balsam apple, African cucumber and
ampalaya. Botanically, this plant is known as Momordica charantia – it is a member of
the gourd family, along with its cousins, pumpkin, acorn squash and zucchini. The plant
itself is a tropical vine and looks a bit like a very warty cucumber! Bitter melon has been
used in a number of traditional medicines as a treatment for diabetes.

Analysis of bitter melon indicates that it is very high in antioxidants, a protein that seems
to be active against tumor cells, [1] enzymes and fatty acids. It also contains charantin,
which appears to be responsible for its effects on blood sugar, vicine and a substance
which appears to mimic insulin—polypeptide p.

What is the Evidence that Bitter Melon Can

Benefit Diabetes?
There are two main lines of evidence that bitter melon could potentially be useful in
treating diabetes. These two lines of evidence are that bitter melon can lower blood
sugar levels and lower blood triglyceride levels. These studies indicated that this can
happen in cells, animal studies and in some human studies.

At this point, the evidence is limited, but very promising because bitter melon appears to
be safe in clinical studies and because of the long-term history of bitter melon as a
food—and as a traditional medicine for diabetes. There is one major safety exception,
however—any individual with a condition known as glucose-6-phosphate
dehydrogenase (G6PD) deficiency. In these individuals, the vicine can, in theory, cause
a form of anemia, headaches, fever, stomach pain and possibly coma.

A recent paper compared the effect of bitter melon and metformin in newly diagnosed
T2D patients and found that bitter melon (at either 500, 1000 or 2000 mg per day) was
effective at lowering blood sugar levels. Metformin at 1000 mg/day, however, was
slightly more effective than any of the doses of bitter melon. In this study, the bitter
melon seeds were removed and the pulp was dried and standardized to contain 0.04-
0.05% charantin in 500 mg of the dried powder.[1]

Another study shown that bitter melon may lower A1c percentages, though the way the
study was designed makes it difficult to determine if these decreases were significant.
Overall, while bitter melon seems to show significant abilities to lower blood sugar
levels, there have only been a few human studies and most of them have not been
designed well enough to come to any conclusions.[2] There have been no published
studies to date as far as lowering triglyceride levels in people with diabetes

Is Bitter Melon Recommended for People with

Diabetes?
At this point, no recommendation for using bitter melon can be made, but it does appear
to be safe for adults. If you decide to take bitter melon, you should know that it may
interact with any diabetes medication, potentially seriously reducing the blood sugar
levels and inducing hypoglycemia or seriously low blood sugar levels.

You can include bitter melon as a food, juice or in a smoothie. It is often available at
Asian or African specialty groceries. As a food, it can be lightly fried, boiled, steamed or
roasted. The skin should be peeled and the seeds removed after cutting the bitter melon
lengthwise. After removing the seeds, cut the bitter melon into chunks and cook. It can
be a side dish or added to soups and stews.

If it is too bitter, after cutting into chunks, blanch in boiling water for 2-3 minutes and let
it drain on a towel for about 10 minutes—then cook it as planned. You can also make
bitter melon juice by removing the rind and seeds and cutting it into chunks—then, put
the pieces into a juicer or add to your favorite smoothie recipe. You can add ginger,
stevia or lemon to reduce the bitterness or just add some fruit such as apples or pears.

You can also find bitter melon tea in some specialty stores. There are no
recommendations for bitter melon tea, but 2-4 cups of tea per day are often traditionally
recommended.

Why are bitter foods good for diabetics?

o Bitter foods stimulate the gall bladder to produce bile—this helps with the
digestion of fats. This may be how bitter melon decreases the triglyceride levels in
animal studies.
 2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4027280/

Antidiabetic effects of Momordica charantia (bitter melon) and its

medicinal potency
Baby Joseph* and D Jini

Reviewed by Arun Kumar

Author information ► Article notes ► Copyright and License information ►

Abstract
Go to:

1. Introduction
Diabetes mellitus is considered as one of the five leading causes of death in the world[1].
Diabetes mellitus is a major global health concerning with a projected rise in prevalence from
171 million in 2000 to 366 million in 2030[2]. It is a syndrome of disordered metabolism,
usually due to a combination of hereditary and environmental causes, resulting in abnormally
high blood sugar levels (hyperglycemia)[3]. Being a major degenerative disease, diabetes is
found in all parts of the world and it is becoming the third most lethal disease of mankind and
increasing rapidly[4]. It is the most common endocrine disorder, affecting 16 million individuals
in the United States and as many as 200 million individuals worldwide. Diabetes has been a
clinical model for general medicine[5]. Complementary and alternative medicine involves the
use of herbs and other dietary supplements as alternatives to mainstream western medical
treatment. A recent study has estimated that up to 30% of patients with diabetes mellitus use
complementary and alternative medicine[6].
Medicinal plants and its products continue to be an important therapeutic aid for alleviating the
ailments of human kind[7]–[9]. Herbs for diabetes treatment are not new. Since ancient times,
plants and plant extracts were used to combat diabetes. Many traditional medicines in use are
derived from medicinal plants, minerals and organic matter. The World Health Organization
(WHO) has listed 21 000 plants, which are used for medicinal purposes around the world.
Among them, 150 species are used commercially on a fairly large scale[1],[10].
Momordica charantia (M. charantia), also known as bitter melon, karela, balsam pear, or bitter
gourd, is a popular plant used for the treating of diabetes-related conditions amongst the
indigenous populations of Asia, South America, India, the Caribbean and East Africa[11],[12].
Its fruit has a distinguishing bitter taste, which is more pronounced as it ripens, hence the name
bitter melon or bitter gourd. Biochemical and animal model experiments have produced
abundant data and hypotheses accounting for the anti-diabetic effects of M. charantia. In
comparison, clinical studies with human subjects are sparse and low quality in design.
Diabetes mellitus is well known clinical entity with various late complications like retinopathy,
neuropathy, nephropathy, etc. Natural products are known to play an important role in
pharmaceutical biology[13]. Specific plant knowledge may provide insight for strategic
consumption and sustainable use. The alternate medicine system is now gaining momentum with
the knowledge of active principles identified from plant species[14]. M. charantia has significant
antidiabetic as well as hypolipidemic activity so that it can be used as an adjuvant along with
allopathic treatment of medicine to treat diabetes as well as to delay the late complications of
diabetes. In the present review, we have elucidated the possible antidiabetic activity of M.
charantia and its medicinal potency responsible for the hypoglycemic activity.
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2. Plant-based anti-diabetic medicine

Plant-based medicine has been used cost-effectively worldwide to treat diabetes. In fact, in many
parts of the world, especially poor countries, this may be the only form of therapy available to
treat diabetic patients. There are several reviews by different authors about anti-diabetic herbal
plants[1],[14]–[17]. Ayurveda and other traditional medicinal systems for the treatment of
diabetes describe a number of plants used as herbal drugs. Hence, they play an important role as
alternative medicine due to less side effects and low cost. The active principles present in
medicinal plants have been reported to possess pancreatic β cells regenerating, insulin releasing
and fighting the problem of insulin resistance[18]. Hyperglycemia is involved in the etiology of
development of diabetic complications. Hypoglycemic herbs increase insulin secretion, enhance
glucose uptake by adipose or muscle tissues and inhibit glucose absorption from intestine and
glucose production from liver[19]. Insulin and oral hypoglycemic agents like sulphonylureas and
biguanides are still the major players in the management, but there is quest for the development
of more effective anti-diabetic agents.
From the current literature, it is evident that M. charantia is the most widely used and popular
anti-diabetic plant. Thus, this review will concentrate mainly on M. charantia and its anti
diabetic properties.
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3. The profile of M. charantia

3.1. Plant description

M. Charantia (bitter melon or bitter gourd) (Figure 1) is a flowering vine in the family
Cucurbitaceae. It is a tropical plant that is widely cultivated in Asia, India, East Africa, and
South America for its intensely bitter fruits that are commonly used in cooking and as a natural
remedy for treating diabetes[20]. It is a climbing perennial that usually grows up to 5 m, and
bears elongated fruits with a knobbly surface. It is a useful medicinal and vegetable plant for
human health and one of the most promising plants for diabetes[21].
Figure 1.

M. charantia plant.

3.2. Nutrient profile

Bitter melon is a powerful nutrient-dense plant composed of a complex array of beneficial
compounds. These include bioactive chemicals, vitamins, minerals and antioxidants which all
contribute to its remarkable versatility in treating a wide range of illnesses. The fruits contain
high amounts of vitamin C, vitamin A, vitamin E, vitamins B1, B2 and B3, as well as vitamin B9
(folate). The caloric values for leaf, fruit and seed were 213.26, 241.66 and 176.61 Kcal/100 g
respectively[22].
The fruit is also rich in minerals including potassium, calcium, zinc, magnesium, phosphorus and
iron, and is a good source of dietary fiber (bitter melon “monograph”, 2008). Medicinal value of
bitter melon has been attributed to its high antioxidant properties due in part to phenols,
flavonoids, isoflavones, terpenes, anthroquinones, and glucosinolates, all of which confer a bitter
taste[23].

3.3. Phytochemistry
The main constituents of bitter melon which are responsible for the antidiabetic effects are
triterpene, proteid, steroid, alkaloid, inorganic, lipid, and phenolic compounds[24],[25]. Several
glycosides have been isolated from the M. charantia stem and fruit and are grouped under the
genera of cucurbitane-type triterpenoids[26],[27]. In particular, four triterpenoids have AMP-
activated protein kinase activity which is a plausible hypoglycaemic mechanism of M.
charantia[27].
M. charantia fruits consist glycosides, saponins, alkaloids, reducing sugars, resins, phenolic
constituents, fixed oil and free acids[28]. M. charantia consists the following chemical
constituents including alkaloids, charantin, charine, cryptoxanthin, cucurbitins, cucurbitacins,
cucurbitanes, cycloartenols, diosgenin, elaeostearic acids, erythrodiol, galacturonic acids,
gentisic acid, goyaglycosides, goyasaponins, guanylate cyclase inhibitors, gypsogenin,
hydroxytryptamines, karounidiols, lanosterol, lauric acid, linoleic acid, linolenic acid,
momorcharasides, momorcharins, momordenol, momordicilin, momordicin, momordicinin,
momordicosides, momordin, momordolo, multiflorenol, myristic acid, nerolidol, oleanolic acid,
oleic acid, oxalic acid, pentadecans, peptides, petroselinic acid, polypeptides, proteins, ribosome-
inactivating proteins, rosmarinic acid, rubixanthin, spinasterol, steroidal glycosides, stigmasta-
diols, stigmasterol, taraxerol, trehalose, trypsin inhibitors, uracil, vacine, v-insulin, verbascoside,
vicine, zeatin, zeatin riboside, zeaxanthin, zeinoxanthin amino acids-aspartic acid, serine,
glutamic acid, thscinne, alanine, g-amino butyric acid and pipecolic acid, ascorbigen, b-
sitosterol-d-glucoside, citrulline, elasterol, flavochrome, lutein, lycopene, pipecolic acid. The
fruit pulp has soluble pectin but no free pectic acid. Research has found that the leaves are
nutritious sources of calcium, magnesium, potassium, phosphorus and iron; both the edible fruit
and the leaves are great sources of the B vitamins[29].

3.4. Bioactive compounds

Based on the multitude of medical conditions that bitter melon can treat, scientists are more and
more interested in studying its bioactive compounds and their actions on the body. However, as
many studies report, there has been substantial emphasis on the anti-diabetic compounds and
their hypoglycemic properties[30],[31]. A number of reported clinical studies have shown that
bitter melon extract from the fruit, seeds, and leaves contain several bioactive compounds that
have hypoglycemic activity in both diabetic animals and humans[32],[33].
Momordicine II and 3-hydroxycucurbita-5, 24-dien-19-al-7, 23- di-O-β-glucopyranoside (4),
were isolated as saponins from M. charantia. Both compounds showed significant insulin
releasing activity in MIN6 β-cells at concentration of 10 and 25 µg/mL[34]. The major
compounds that have been isolated from bitter melon and identified as hypoglycemic agents
include charantin, polypeptide-p and vicine.

3.4.1. Charantin
Charantin is a typical cucurbitane-type triterpenoid in M. charantia and is a potential substance
with antidiabetic properties[35],[36]. Pitiphanpong et al. demonstrated that charantin could be
used to treat diabetes and can potentially replace treatment[37]. It is a mixture of two
compounds, namely, sitosteryl glucoside and stigmasteryl glucoside[37]. Chen et al. isolated 14
cucurbitane triterpenoids, kuguacins, including two pentanorcucurbitacins, one
octanorcucurbitacin, and two trinorcucurbitacins, along with six known analogues from the vines
and leaves of M. charantia[38]. The charantin from bitter melon fruit was extracted and
estimated by high performance thin layer chromatographic method[39].
Studies have reported that the compound is more effective than the oral hypoglycemic agent
tolbutamide[12]. In a study, two aglycones of charantin were isolated and identified as sitosterol
and stigmastadienol glycosides, however, when tested separately for their hypoglycemic
effects in vivo, these two constituents did not produce any notable changes in blood glucose
levels[40]. This is an indication that charantin may contain other specific components, yet to be
identified, that are responsible for the hypoglycemic activity observed in diabetics.

3.4.2. Polypeptide-p
Bitter melon is one of the most commonly used vegetable that contains polypeptide-p and is used
to control diabetes naturally[41]. Polypeptide-p or p-insulin is an insulin-like hypoglycemic
protein, shown to lower blood glucose levels in gerbils, langurs and humans when injected
subcutaneously[42]. The p-insulin works by mimicking the action of human insulin in the body
and thus may be used as plant-based insulin replacement in patients with type-1 diabetes[43].
Recently, Wang et al.have cloned and expressed the 498 bp gene sequence coding for the M.
charantia polypeptide p gene and have also proved the hypoglycemic effect of the recombinant
polypeptide in alloxan induced diabetic mice[44]. The oral intake of the extract from bitter
melon seeds does produce hypoglycemic effects in streptozotocin (STZ) induced type-1 diabetic
rats[32]. This indicates that compounds in bitter melon seeds other than p-insulin may also be
effective in the treatment of type-1 diabetes.

3.4.3. Vicine
The other major compound that has been isolated from the seeds of bitter melon is a glycol
alkaloid known as vicine[45]. This pyrimidine nucleoside has been shown to induce
hypoglycemia in non-diabetic fasting rats by intraperitoneal administration[46]. However, vicine
found in fava bean has been shown to induce favism, an acute disease characterized by hemolytic
anemia, in individuals with a hereditary loss of the enzyme glucose-6-
phosphatedehydrogenase[47]. Although there have been no reports on favism induced by bitter
melon, individuals susceptible to the disease should avoid eating the fruit. Further studies are
required to ensure the safety and efficacy of using vicine to treat hyperglycemia.

3.4.4. Other components

Many other bitter melon constituents have been identified and isolated by various extraction
techniques. The first study to show the in vivo hypoglycemic activity of the major compounds of
bitter melon was done by a group of Japanese scientists. They isolated 11 compounds by
fractionation of a methanol extract from dried bitter melon fruits. The structure of three
cucurbitane triterpenoids were determined, as well as two other major compounds that were
tested and shown to significantly lower blood glucose levels in diabetic mice[21]. Four
compounds that may be responsible for the bitter taste of the plant were isolated and identified as
momordicosides K and L, and momordicines I and II. The last two compounds isolated were
identified as sitosterol and stigmastadienol, the aglycones of charantin[40].
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4. Medicinal properties of M. charantia

Bitter melon is traditionally known for its medicinal properties such as antidiabetic, anticancer,
anti-inflammation, antivirus, and cholesterol lowering effects. It contains many phenolic
compounds that may have the potential as antioxidant and antimutagen[25],[48]. The fruit,
stems, leaves and roots of bitter melon have all been used in traditional medicine to help treat
ailments such as hyperlipidemia, digestive disorders, microbial infections and menstrual
problems[49]. Bitter melon has been shown to possess powerful antiviral properties that can
stimulate the immune system and activate the body's natural killer cells to help fight off viruses
such as white spot syndrome virus and human immunodeficiency virus[50]–[52]. Studies have
also shown that bitter melon has anti-carcinogenic properties and can be used as a cytotoxic
agent against many types of cancer[53]. Ray et al. showed that the extract of bitter melon
modulates signal transduction pathways for inhibition of breast cancer cell growth and can be
used as a dietary supplement for prevention of breast cancer[54].
Bitter melon extract can also be used as a broad-spectrum antibacterial agent to fight off
infections caused by Escherichia coli, Salmonella, Staphylococcus aureus, Staphylococcus,
Pseudomonas, and Streptobaccilus[55]. In addition, the plant possesses anti-helmintic properties,
which are effective in the treatment of malaria. Traditionally, bitter melon has also been used as
an abortifacient agent used to induce abortions. Therefore, pregnant women are advised to avoid
consumption of the plant[50]. The extract of the seed also have antispermatogenic effect[56].
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5. Anti-diabetic effect of M. charantia

There are many traditional herbal remedies that have been used to treat diabetes in Asia and
other developing countries[16],[57]–[59]. M. charantia is one of the plants that has been
investigated thoroughly for the treatment of diabetes[60]. With the traditional use supported by
modern scientific evidence of the beneficial function of M. charantia, it is one of the most
promising plants for diabetes today[11],[61]. Investigation of the traditional uses of M.
charantia in India revealed that it is one of the most important plant for lowering blood glucose
levels in patients with diabetes[43].

5.1. Possible modes of action of M. charantia and its extract

M. charantia and its various extracts and components are believed to exert their hypoglycemic
effects via different physiological, pharmacological and biochemical modes[62]–[64]. The
possible modes of the hypoglycemic actions of M. charantia and its various extracts and
compounds are its hypoglycemic effect[67],[70], stimulation of peripheral and skeletal muscle
glucose utilisation[71],[72], inhibition of intestinal glucose uptake[73]–[75], inhibition of
adipocyte differentiation[76], suppression of key gluconeogenic enzymes[77],[78], stimulation
of key enzyme of HMP pathway[77], and preservation of islet β cells and their functions[66].
Today, over 140 different studies worldwide have investigated anti-hyperglycemic and
hypoglycemic effects of the different extracts and ingredients of M. charantia in both human and
animal models[32],[33],[62].
According to Kim and Kim, M. charantia extract suppressed the activation of mitogen-activated
protein kinases (MAPKs) including stress-activated protein kinase/c-Jun N-terminal kinase
(SAPK/JNK), p38, and p44/42, and the activity of NF-κB[65]. The findings suggest that M.
charantia protects pancreatic β-cells through down-regulation of MAPKs and NF-κB in
MIN6N8 cells. A similar study suggest that M. charantia improves the serum and liver lipid
profiles and serum glucose levels by modulating PPAR-γ gene expression[66]. According to
Ragasa et al., clerosterol and 5α-stigmasta-7-en-3β-ol were isolated as sterols from M.
charantia having significant hypoglycemic effects[67]. M. charantia was identified to possess a
potent neuroprotective activity against global cerebral ischemia-reperfusion induced neuronal
injury and consequent neurological deficits in diabetic mice[68]. Protein tyrosine phosphatase 1B
(PTP1B), a negative regulator of insulin signaling, has served as a potential drug target for the
treatment of type 2 diabetes[69].
M. charantia, its extracts and isolated components are believed to exert their hypoglycaemic
effects via different physiological and biochemical processes. These include insulin secretagogue
like effect, stimulation of skeletal muscle and peripheral cell glucose utilization, inhibition of
intestinal glucose uptake, inhibition of adipocyte differentiation, suppression of key
gluconeogenic enzymes, stimulation of key enzymes, HMP pathway and preservation of
pancreatic islet cells and their functions.
5.2. Preservation of pancreatic β cells and insulin secretion
It was previously demonstrated by Jeewathayaparan et al. that oral administration of M.
charantia could lead to the secretion of insulin from endocrine pancreatic β cells[79]. This
observation was further confirmed by Ahmed et al. who investigated the effect of daily oral
administration of M. charantia fruit juice and the distribution of α, β and δ cells in the pancreas
of STZ-induced diabetic rats using immunohistochemical methods[80]. The feeding of alcoholic
extract from M. charantia showed definite improvement in the islets of Langerhans[81].
Physiological experiments have also shown that M. charantia can stimulate insulin secretion
from the endocrine pancreas and elicit glucose uptake in the liver[74]. Current evidence therefore
indicates that the recovery and subsequent increase in the number of insulin producing cells
followed by the release of insulin may be part of the several pathways by which M.
charantia exerts its hypoglycemic effects. In addition to the properties mentioned above, M.
charantia and its extracts may possess cell-like proliferation and growth-like properties similar
to that of insulin[82]. Nevertheless, further experiment are required, at least at the molecular
level, to determine the precise mechanisms whereby M. charantia can either repair damaged β
cells or prevent their death.

5.3. M. charantia and glucose metabolism

Insulin plays a major biochemical role in stimulating the uptake of glucose by different cells of
the body for the production of energy[83],[84]. Since M. charantia and its various extracts and
components have been reported to exert hypoglycemic effects, and then it is important to
understand whether M. charantiamay have a direct effect in inducing a reduction in blood
glucose level[62]. Previous studies have shown that both the aqueous and alcoholic extracts of
the fruit of M. charantia can inhibit the activities of fructose 1, 6-diphosphatase and glucose-6-
phosphatase and at the same time stimulating the action of glucose-6-phosphatase
dehydrogenase[85]. It was previously reported that M. charantia and its various extracts can
stimulate peripheral cell glucose uptake[71],[72]. A number of studies have investigated the
effect of the powder and chloroform extract of M. charantia in comparison with insulin on
glucose and amino acid uptakes by skeletal L6 myotubes and Na+ and K+ glucose uptakes by
jejunum brush border membrane vesicles in both age-matched control and STZ-induced diabetic
rats. The results show that either the lyophilized fruit juice or chloroform extract at 5-10 µg/mL
can stimulate 3H-deoxyglucose and 14C-Me AIB (N-methyl-amino-α-isobutyric acid) uptakes by
L6 myotubes. These effects were similar in magnitude to the effects obtained with 100 nmol/L
insulin. Incubation of either insulin or M. charantia juice in the presence of wortmannin (a
phosphatidylinositol 3-kinase inhibitor) resulted in a marked inhibition of 3H-deoxyglucose
uptake by L-6 myotubes[71]. Together, the results have clearly demonstrated that M.
charantia contains insulin like properties, similar to one phytochemical component of M.
charantia called V-insulin[62].
In addition to its insulin-like effects on skeletal muscle cells, daily oral intake of M.
charantia fruit juice over a period of 10 weeks significantly reduced the amount of Na+ and K+-
dependent 14C-D-glucose absorbed by rat jejunum brush border membrane vesicle compared to
vesicles obtained from STZ-induced diabetic rats[80]. Taken together, these results clearly
demonstrated that M. charantia and its extracts can directly regulate blood glucose via two
mechanisms. Firstly, it can regulate how much glucose is absorbed by the gut into the blood
following a meal and secondly, it can stimulate glucose uptake into skeletal muscle cells just like
insulin. Moreover, it seems to exert its effect via the same intracellular signaling pathways as
insulin in regulating glucose metabolism in the body[86].

5.4. Animal studies of M. charantia

Various animal studies have repeatedly shown hypoglycaemic effects of the seeds, fruit pulp,
leaves and whole plant of M. charantia in normal animals[74],[87],[88]. In particular, M.
charantia improves glucose tolerance and suppresses postprandial hyperglycaemia in
rats[71],[75],[73], and M. charantia extract can enhance insulin sensitivity and lipolysis[89],[90].
Some studies also claimed that the hypoglycaemic effect of M. charantia was comparable with
oral medications such as tolbutamide[70],[91], chlorpropamide and glibenclamide[92],[93].
Abundant biochemical data have shed light upon possible mechanisms of the anti-diabetic
actions of M. charantia with the recurring theme being activation of the AMP-activated protein
kinase system[94]–[97]. Other studies suggested a role of the a- and g-peroxisome proliferator-
activated receptors (PPARa and PPARg) which are pivotal in lipid and glucose haemostasis and
may mitigate insulin resistance[98],[99].
The alcoholic extract of M. charantia was quite effective in lowering blood sugar levels and islet
histopathology also showed improvement. The lowered blood sugar and improvement in islet
histology remained as such even after discontinuation of extract feeding for 15 days[81]. The
acetone extract of whole fruit powder of M. charantia in doses 0.25, 0.50 and 0.75 mg/kg body
weight lowered the blood glucose from 13.3% to 50.0% after 8 to 30-day treatment in alloxan
diabetic albino rats, confirming anti hyperglycemic effect of this plant in diabetic animals and
humans[100].

5.5. Clinical studies of M. charantia

More than 1 000 herbal products have been used by diverse cultures of the world to treat
hyperglycemia and among them bitter melon (M. charantia) is one of the most popular herbal
resource[101]. An earlier study on the development of diabetic cataracts demonstrated that blood
sugar level-dependent cataract formation was slowed down by the consumption of bitter gourd
fruit extract in association with better glucose homeostasis[102]. Today, processed bitter gourd
in the form of capsules or tablets is commonly advertised and sold. The products are marketed
under the brand names Gourdin, Karela, and Glucobetic in Canada, India, the United Kingdom,
the United States, and many Asian countries. Products can also be ordered online. However,
Diabetes UK has released a warning with regard to the use of Karela capsules, because it is not
yet known what dose is safe when taken with other antidiabetic agents, and there is a lack of
information on other potential bioactive components of the capsules[103].
Compared with animal studies, clinical studies regarding the hypoglycaemic effects of M.
charantia have been sparse and sporadic. Lakholia, a physician, was probably the first to
document the therapeutic effect of bitter melon in 1956 using himself as the subject[104]. As we
reviewed in the recent studies fulfilling our search criteria, we noticed that the majority of them
lacked proper controls or suffered from poor methodologies without baseline characterizations as
tabulated in Table 1.
Table 1

Clinical studies of M. charantia.

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6. Conclusion
The concept of food as medicine is a central theme in dietetic and nutritional sciences. M.
charantia has been used as dietary supplements and ethnomedicine throughout centuries for
relieving symptoms and conditions related to what we know in modern days as diabetes. To
date, M. charantia has been extensively studied worldwide for its medicinal properties to treat a
number of diseases[61]. It is described as a versatile plant worthy of treating almost any disease
inflicted on mankind. This may be due to the fact that the plant possesses over 225 different
medicinal constituents[62]. These different compounds may act either separately or together to
exert their medicinal effects. In relation to diabetes, only charantin, insulin-like peptide and
alkaloid-like extracts possess hypoglycemic properties similar to the plant itself or its crude
extracts. These different compounds seem to exert their beneficial effects via several
mechanisms to control and treat diabetes mellitus.
Despite the abundant data from biochemical and animal studies, available clinical data as
reviewed in the present article are often flawed by small sample size, lack of control and poor
study designs. The present review supports the need for better-designed clinical trials with
sufficient sample size and statistical power to further indicate the acclaimed efficacy of M.
charantia as a natural nutritional treatment for diabetes mellitus. In particular, M. charantia may
be a feasible option for ethnic minorities who have a high prevalence of diabetes but prefer
treatment based on natural products according to their cultural beliefs.
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Acknowledgments
The authors gratefully acknowledged to our Malankara Catholic College Correspondent Fr. Prem
Kumar (M.S.W) given encouragement and support for preparation of this manuscript. We wish
to express our sincere thanks to Mr. K. Suresh (Dept. of Microbiology), Dr. Sujatha (ICBM) and
the research scholars in the Interdisciplinary Research Centre for updated article collection and
all the efficient supports of this review preparation. This work was financially supported by
CSIR, Head HRDG, New Delhi (Grant No. 27/0237/10 EMR II).
 3) http://www.diabetes.co.uk/natural-therapies/bitter-melon.html

Bitter Melon and Diabetes

Bitter melon can reduce blood glucose levels but more research is required

Bitter melon, also known as bitter gourd or karela (in India), is a unique vegetable-fruit that can be
used as food or medicine.

It is the edible part of the plant Momordica Charantia, which is a vine of the Cucurbitaceae family
and is considered the most bitter among all fruits and vegetables.

The plant thrives in tropical and subtropical regions, including:

 South America
 Asia
 parts of Africa
 the Caribbean
The bitter melon itself grows off the vine as a green, oblong-shaped fruit with a distinct warty exterior
- though its size, texture and bitterness vary between the different regions in which it grows - and is
rich in vital vitamins and minerals.
 Home
 Treatment
 Herbal Remedies
 Bitter Melon and Diabetes
Treatment
 Treatment for type 1 diabetes
 Treatment for type 2 diabetes
 Reversing diabetes
 Making diabetes less painful
 Alternative treatment
 Herbal remedies
o Aloe vera
o Bilberry extract
o Bitter melon
o Cinnamon
o Coconut
o Fenugreek
 o Ginger
 Transplants
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 Effects of diabetes
 Vitamins

Bitter Melon and Diabetes

Bitter melon can reduce blood glucose levels but more research is required

Bitter melon, also known as bitter gourd or karela (in India), is a unique vegetable-fruit that can be
used as food or medicine.

It is the edible part of the plant Momordica Charantia, which is a vine of the Cucurbitaceae family
and is considered the most bitter among all fruits and vegetables.

The plant thrives in tropical and subtropical regions, including:

 South America
 Asia
 parts of Africa
 the Caribbean
The bitter melon itself grows off the vine as a green, oblong-shaped fruit with a distinct warty exterior
- though its size, texture and bitterness vary between the different regions in which it grows - and is
rich in vital vitamins and minerals.

How does it affect diabetes?

In addition to being a food ingredient, bitter melon has also long been used as a herbal remedy for a
range of ailments, including type 2 diabetes.

The fruit contains at least three active substances with anti-diabetic properties, including charantin,
which has been confirmed to have a blood glucose-lowering effect, vicine and an insulin-like
compound known as polypeptide-p.

These substances either work individually or together to help reduce blood sugar levels.

It is also known that bitter melon contains a lectin that reduces blood glucose concentrations by
acting on peripheral tissues and suppressing appetite - similar to the effects of insulin in the brain.
 This lectin is thought to be a major factor behind the hypoglycemic effectthat develops after eating
bitter melon.

Scientific evidence
A number of clinical studies have been conducted to evaluate the efficacy of bitter melon in
the treatment of diabetes
n January 2011, the results of a four-week clinical trial were published in the Journal of
Ethnopharmacology, which showed that a 2,000 mg daily dose of bitter melon significantly
reduced blood glucose levels among patients with type 2 diabetes, although the hypoglycemic effect
was less than a 1,000 mg/day dose of metformin. [68]
Other older studies have also suggested an association between bitter melon intake and improved
glycemic control, while a report published in the March 2008 issue of Chemistry and Biology found
that bitter melon increased cellular uptake of glucose and improved glucose tolerance. [69]
However, research published in the Journal of Clinical Epidemiology in 2007 failed to show any
benefits of bitter melon for poorly controlled type 2 diabetes, while another clinical review published
two years later in the British Journal of Nutrition stated that more, better-designed and clinical trials
are required to confirm the fruit’s role in diabetes treatment. [70]

What other health benefits does it have?

Bitter melon is used in traditional medicine for:

 Colic
 Fever
 Burns
 Chronic cough
 Painful menstruation
 Skin conditions

It is also used to heal wounds, assist childbirth and, in parts of Africa and Asia, prevent or treat
malaria and viral diseases such as measles and chicken pox.

In addition, researchers from Saint Louis University in the US say they have shown that an extract
from bitter melon can kill breast cancer cells and prevent them from growing and spreading
 4) https://www.diabetesselfmanagement.com/blog/bitter-melon-diabetes/

Bitter Melon, Diabetes

My husband was diagnosed with Type 2 four months ago… he had a blood glucose
reading of 370. [The] doctor put him on metformin — 1,000 mg a day, which brought
his blood glucose down to the low 200’s. So the doctor upped his meds to 2,000 mg a
day.

Then someone told her about bitter melon tea, and she bought some at a local Asian grocery. He
started drinking one cup of tea in the morning and one in the evening. The very next day, his fasting
glucose dropped to around 80. He stopped his metformin and his fasting glucose levels have been
under 100 ever since.

His A1C dropped from 13.5 to 6.3. Since he has only been on the tea for a few weeks, his A1C will
probably drop further at the next test. This is a man who is heavy, eats lots of pasta and rice, and
whose exercise is “walking the dog twice a week.” Nothing else in his lifestyle has changed.

Debbie is sure it’s the bitter melon tea that’s controlling the blood glucose. But one person’s
experience is not enough. It’s “anecdotal evidence.” Is there any scientific backup for his story? Not
much, but some.

A study by researchers in Australia, China, and Germany found that four compounds in bitter melon
that “activate an enzyme that is responsible for… transporting glucose from the blood into the cells.”
The enzyme is called AMPK, the same one activated by exercise.
According to the article, published in March 2008 in the journal Chemistry & Biology, AMPK moves
glucose transporter molecules to the surface of cells. There they help bring glucose from the blood
into the cells. Science Daily reported, “This is a major reason that exercise is recommended as part
of the normal treatment program for someone with Type 2 diabetes.”
Nearly all scientific work on bitter melon comes from China, Japan, India, and other Asian countries,
and most studies have been in rats and mice. You can see a list here.
But when it comes to research on people, one review done in Malaysia found only two good studies,
and the results were inconclusive. “More research is needed,” the authors conclude.

What is bitter melon?

According to Wikipedia, bitter melon is a fruit, but not one you are likely to eat raw. It looks like a
pockmarked cucumber, and the taste is described as “chalky” and “unpleasant” on various Web sites
like this Chinese cooking site.
Bitter melon’s scientific name is Momordica charantia. In English, it is called bitter melon, bitter
gourd, or bitter squash. It has long been used in Chinese recipes, often in soups. But the effort in
cooking and not-so-great taste has kept many people from eating it regularly.

In the 60’s, 70’s, and 80’s, studies of bitter melon in Asia found a chemical called charantin, which
reduced blood glucose in rabbits. According to Livestrong.com, other “insulin-like compounds” in
bitter melon include vicine and polypeptide-P.
So it may be that bitter melon reduces insulin resistance, or it may be that bitter melon acts as a
substitute for insulin, at least when it comes to getting glucose into cells.
In a 2007 study, the Philippine Department of Health determined that 100 milligrams per kilogram of
body weight of bitter melon each day reduces glucose as much as 2.5 mg/kg of glyburide, a
sulfonylurea drug, taken twice per day. Tablets of bitter melon extract are now sold in the Philippines
as a food supplement and exported to many countries.
Side effects and costs
According to Livestrong, there is a risk of hypoglycemia if you take too much bitter melon, especially
if you are taking insulin or a sulfonylurea or thiazolidinedione drug. Drinking bitter melon juice is
sometimes associated with stomach pain or diarrhea.

But according to users, bitter melon tea is a whole different story. Most say it tastes good, “better
than green tea,” one commented. It’s also easy to prepare and easy to buy, either at an Asian
grocery or online. A month’s supply costs about $5 at a store, maybe $12 online. Bitter melon
capsules are more expensive.

Some people will probably not see the same astounding benefits as Debbie’s husband. In addition to
normalizing glucose, his triglyceride levels have returned to normal or near-normal after years of
being dangerously high.

It might be that Asian people will tend to improve more on bitter melon tea than non-Asian people. It
might also take longer than the one day Debbie’s husband needed to see results. She wrote that a
friend with diabetes didn’t see results for two weeks, but then his glucose levels came down to the
normal range and stayed there.

But we won’t know until we try. A good dose would probably be one cup of bitter melon tea with
breakfast and one with dinner. If you eat carbs at lunch, perhaps drink another cup then. I wouldn’t
take it without eating, to avoid lows. It should probably be avoided if you are pregnant, and should
not be given to children because of lows.

You can certainly also try cooked bitter melon or bitter melon capsules, but if the tea works for you,
that seems easiest and tastiest, and cheaper than the capsules.

I hope some readers will try bitter melon and let us know your results. Or maybe you have already
tried it. We’d like to know. Although it probably won’t work for everyone, bitter melon might be a good
or better than vinegar or prescription medicines for many people. Of course, healthy eating and some
physical activity are still important.
 5) https://www.thediabetescouncil.com/surprising-benefits-of-bitter-melon-for-diabetes/

Surprising Benefits of Bitter Melon

for Diabetes
Bitter melon is also known as karela, bitter gourd, balsam apple, African cucumber and
ampalaya. Botanically, this plant is known as Momordica charantia – it is a member of
the gourd family, along with its cousins, pumpkin, acorn squash and zucchini. The plant
itself is a tropical vine and looks a bit like a very warty cucumber! Bitter melon has been
used in a number of traditional medicines as a treatment for diabetes.

Analysis of bitter melon indicates that it is very high in antioxidants, a protein that seems
to be active against tumor cells, [1] enzymes and fatty acids. It also contains charantin,
which appears to be responsible for its effects on blood sugar, vicine and a substance
which appears to mimic insulin—polypeptide p.

What is the Evidence that Bitter Melon Can

Benefit Diabetes?
There are two main lines of evidence that bitter melon could potentially be useful in
treating diabetes. These two lines of evidence are that bitter melon can lower blood
sugar levels and lower blood triglyceride levels. These studies indicated that this can
happen in cells, animal studies and in some human studies.

At this point, the evidence is limited, but very promising because bitter melon appears to
be safe in clinical studies and because of the long-term history of bitter melon as a
food—and as a traditional medicine for diabetes. There is one major safety exception,
however—any individual with a condition known as glucose-6-phosphate
dehydrogenase (G6PD) deficiency. In these individuals, the vicine can, in theory, cause
a form of anemia, headaches, fever, stomach pain and possibly coma.

A recent paper compared the effect of bitter melon and metformin in newly diagnosed
T2D patients and found that bitter melon (at either 500, 1000 or 2000 mg per day) was
effective at lowering blood sugar levels. Metformin at 1000 mg/day, however, was
slightly more effective than any of the doses of bitter melon. In this study, the bitter
melon seeds were removed and the pulp was dried and standardized to contain 0.04-
0.05% charantin in 500 mg of the dried powder.[1]

Another study shown that bitter melon may lower A1c percentages, though the way the
study was designed makes it difficult to determine if these decreases were significant.
Overall, while bitter melon seems to show significant abilities to lower blood sugar
levels, there have only been a few human studies and most of them have not been
designed well enough to come to any conclusions.[2] There have been no published
studies to date as far as lowering triglyceride levels in people with diabetes.

Is Bitter Melon Recommended for People with

Diabetes?
At this point, no recommendation for using bitter melon can be made, but it does appear
to be safe for adults. If you decide to take bitter melon, you should know that it may
interact with any diabetes medication, potentially seriously reducing the blood sugar
levels and inducing hypoglycemia or seriously low blood sugar levels.

You can include bitter melon as a food, juice or in a smoothie. It is often available at
Asian or African specialty groceries. As a food, it can be lightly fried, boiled, steamed or
roasted. The skin should be peeled and the seeds removed after cutting the bitter melon
lengthwise. After removing the seeds, cut the bitter melon into chunks and cook. It can
be a side dish or added to soups and stews.

If it is too bitter, after cutting into chunks, blanch in boiling water for 2-3 minutes and let
it drain on a towel for about 10 minutes—then cook it as planned. You can also make
bitter melon juice by removing the rind and seeds and cutting it into chunks—then, put
the pieces into a juicer or add to your favorite smoothie recipe. You can add ginger,
stevia or lemon to reduce the bitterness or just add some fruit such as apples or pears.

You can also find bitter melon tea in some specialty stores. There are no
recommendations for bitter melon tea, but 2-4 cups of tea per day are often traditionally
recommended.

Questions and Answers

 Why are bitter foods good for diabetics?
o Bitter foods stimulate the gall bladder to produce bile—this helps with the digestion
of fats. This may be how bitter melon decreases the triglyceride levels in animal
studies.
 6) http://www.medicalnewstoday.com/articles/317724.php

Bitter melon and diabetes: How does it affect

blood sugar levels?
Diabetes is a condition that affects blood sugar levels and can lead to health issues if not properly
managed. Could eating bitter melon be healthful for those looking to manage diabetes?

The bodies of people with diabetes do not produce enough insulin or are not able to
use insulin effectively, which leads to there being too much glucose in the blood.
Insulin is required so that cells can use it for energy.

A healthful diet and exercise are important for people with diabetes to help them
manage their condition. Certain foods can cause blood sugar levels to spike, which is
problematic.

In this article, we explore whether bitter melon is healthful for people looking to
manage diabetes. As part of this, we analyze the impact bitter melon may have on
blood sugar.

Contents of this article:

 Treating diabetes

 What is bitter melon?

 How does bitter melon affect people with diabetes?

 Using bitter melon as a supplemental diabetes treatment

 Conclusion
Treating diabetes
In type 1 diabetes, high blood sugar is the result of the body not producing enough
insulin.

Type 2 diabetes, however, occurs when the body does not respond correctly to insulin.
Type 2 diabetes is the most common form of diabetes, and people of any age can
develop it.

Many people with diabetes manage their condition well and do not experience further
health problems. A range of medications and lifestyle changes can help people with
diabetes live healthy lives.

However, drug therapies may have some side effects. As such, some people look to
try natural treatments that are free of side effects. To make an informed decision about
these, it helps to understand the science behind these options.

One such natural treatment method is better melon. Although further research is
needed to draw reliable conclusions, some research suggests bitter melon may
normalize blood glucose levels.

What is bitter melon?

Bitter melon has many different names, depending on where you are in the world.
People all around the world have used it for both food and medicine for centuries.

Rich in vitamins and minerals, bitter melon grows on a vine of the Momordica
charantia plant and is the most bitter of all fruits and vegetables.
 Bitter melon grows in tropical and subtropical environments and thrives in:

 South America
 Asia
 the Caribbean
 some parts of Africa

An alternative remedy for centuries, people are said to have used it to manage:

 colic

 fevers

 burns

 coughs

 skin conditions

 childbirth

In parts of Asia and Africa, it has been used to manage symptoms of chicken
pox and measles. And researchers from St. Louis University have even found
evidence that bitter melon can hinder the growth of breast cancer cells.

How does bitter melon affect people with

diabetes?
A number of clinical studies have examined the effect bitter melon has on diabetes to
see whether it could be an effective treatment for normalizing blood glucose.

Effect on blood sugar levels

Researchers believe bitter melon contains substances that cause decreases in blood
glucose and appetite suppression. In this way, it behaves similarly to insulin.
 One study published in the Journal of Ethnopharmacology found that 2,000 mg daily
of bitter melon lowers blood glucose levels considerably in people with type 2
diabetes. The effect was less than taking a 1,000 mg dose of metformin, which is a
medicine often prescribed to control blood sugar levels.

Effect on glucose intolerance

Another study from 2008, suggests bitter melon improves glucose intolerance and
suppresses blood glucose levels after meal consumption in animal studies.

However, other studies suggest any improvement is insignificant or inclusive.

Effect on hemoglobin A1c levels

Another study aimed to determine whether people with diabetes who took bitter
melon supplements could decrease their hemoglobin A1c levels.

A1c levels are the average blood sugar levels over a 2-3 month period. The study
looked to see if bitter melon could reduce A1c levels by at least 1 percent over this
three-month period.

Two groups of people took part in the study:

 people recently diagnosed with type 2 diabetes

 those with poor glucose control, who had A1c levels from 7 to 9 percent

The participants were advised to take two capsules of bitter melon three times daily.

The results of the study, reported in the Journal of Clinical Epidemiology, uncovered
a less than 0.25 percent decrease in A1c levels in the study group.

The placebo group showed no change. The authors noted that the study size was too
small but showed potential for larger studies.
 Compared to no treatment
A 2014 report from Nutrition and Diabetes, looked at four studies that compared
treatment using bitter melon supplements to no diabetic treatment at all.

The authors of the study found no evidence bitter melon had any significant effects on
A1c levels or fasting plasma glucose levels.

They further concluded most of the research to date is inclusive regarding glycemic
outcomes. They believed larger sample sizes could better determine bitter melon's
effectiveness as a supplemental treatment for diabetes.

Further research
A 2016 report published in Current Pharmacology Reports similarly looked at several
studies related to bitter melon including its effects on diabetes.

The authors did find merit in the theories that bitter melon may
have hypoglycemia (low blood glucose) properties.

They also found it may help to reduce the adverse effects of diabetes but felt further
study was warranted to come to any real conclusions.

Using bitter melon as a supplemental diabetes

treatment
Bitter melon is available in many forms, including as:

 a fruit
 a powder
 an herbal supplement
 juice
 The fruit is available at most Asian grocery stores. Powders, supplements, and juices
are available at health food stores and sold by online retailers.

How much to consume

Anyone considering taking bitter melon alongside their diabetes treatment should
consume no more than:

 50-100 milliliters daily (or about 2 to 3 ounces spread throughout the day)

 one small bitter melon per day

Supplements should be taken according to the instructions on the packaging. People

should check with their doctors to see if it is safe to include supplements to their
treatment plan. This is because supplements may counteract the effects of diabetes
medications.

Risks of consuming bitter melon

Excessive consumption of bitter melon may cause stomach troubles,
including diarrhea. Another potential adverse effect is extremely low blood sugar.

Children should not take bitter melon as it has been known to cause vomiting and
diarrhea. Pregnant women should not consume bitter melon in any form because it has
been associated with bleeding, contractions and miscarriage.
Conclusion
Bitter melon is generally safe for most adults. However, as reported by
the International Journal of Environmental Research and Public Health, possible side
effects caused by long-term use have not been studied.

Whilst there may be some benefits, no double-blind, placebo-controlled study (the

gold standard of studies) has proven effectiveness or safety in all people with diabetes.
People with diabetes should use bitter melon with caution, due to the associated
hypoglycemia risks.

People with diabetes wanting to include bitter melon in their treatment plan should
consult with their doctors. They should monitor their blood glucose levels closely
because bitter melon may interact with diabetes medications that might reduce blood
sugar to dangerous levels.

With more research, however, bitter melon may become a standard treatment for
diabetes management.
 7) https://draxe.com/bitter-melon/

Bitter Melon: the Medicinal Fruit for Diabetes,

Cancer & More
Bitter melon (Momordica charantia) is a type of edible, medicinal fruit that is
native to Asia, Africa and parts of the Caribbean. It has a very long history of
use in China, Ayurvedic medicine — a traditional system of healing that has
been practiced for India for over 3,000 years — and also in some of the
healthiest places of the world, such as Okinawa, Japan (one of the world’s
“blue zones“). (1)

Records show that culinary and medicinal uses of bitter melon originated in
India, then were introduced into Traditional Chinese Medicine practices
around the 14th century. Knowing that bitter foods tend to be cleansing for
the body and capable of boosting liver health, the Chinese were attracted to
bitter melon’s extremely sour taste. They began cooking and using the fruit in
recipes, as well as juicing it to create a tonic in order to help treat such
conditions as indigestion, an upset stomach, skin wounds, chronic
coughsand respiratory infections.

Bitter melon has been the focus of well over 100 clinical and observational
studies. It’s best known for its hypoglycemic affects (the ability to lower
blood sugar), and research shows that the melon’s juice, fruit and dried
powder can all be used to mimic insulin’s effects and treat diabetes. (2)
Although researchers state that further studies are required to recommend its
use for certain conditions, according to a 2004 review published in
the Journal of Ethnopharmacology, findings show that bitter melon has some
of the following benefits: (3)

 Managing blood sugar levels and diabetes

 Reducing respiratory infections such as pneumonia
 Lowering inflammation and raising immunity
 Treating abdominal pain, peptic ulcers, constipation, cramps and fluid
retention
 Increasing cancer-protection
 Reducing fevers and coughs
  Lowering menstrual irregularity
 Treating skin conditions including eczema, scabies and psoriasis
 Antiviral, antibacterial and anthelmintic properties (including those that
can be used to prevent or treat parasites, HIV/AIDS, malaria and even
leprosy)
 Treating gout, jaundice and kidney stones
 Managing symptoms of autoimmune disorders including rheumatoid
arthritis

Bitter Melon Nutrition Facts

Momordica charantia goes by several common names around the world,

including bitter melon, bitter gourd, balsam, bitter apple and carilla fruit. It
belongs to the cucurbitaceae plant family and today is primarily grown in two
varieties for its medicinal benefits (M. charantia var. charantia and M.
charantia var. muricata), mostly throughout parts of India.

Over a dozen different species of the plant can be found growing throughout
the world, and the beneficial properties, taste, texture, size and appearance
differ from plant species to species. The most widely grown type of bitter
melon plant produces a small, round fruit that has a distinct, highly sour/tart
taste. The immature fruit is sometimes eaten as a vegetable and added to stir-
fries or other recipes, especially throughout Asia. It can be consumed both
raw and when cooked, as well as used to make a concentrated extract that
contains high levels of anti-inflammatory, antibacterial, antiviral compounds.

 According to the National Bitter Melon Council, at least 32 active

chemicals have been identified in bitter melon.
 What gives the bitter melon plant it’s signature sour flavor is a type of
alkaloid momordicine compound, which is produced in the plant’s fruit
and leaves.
 In immature vegetable form, bitter melon is also a good source of
nutrients including vitamin A, vitamin C, iron and phosphorus.
 One of its most important attributes, Momordica charantia contains
biologically active phytonutrients and antioxidants. These include
chemical compounds such as phenolic acids, glycosides, saponins,
 alkaloids, fixed oils, triterpenes, insulin-like peptides, and certain types
of anti-inflammatory proteins and steroids.
 Studies have identified specific phenolic and flavonoid compounds
within bitter melon that are responsible for many of its anti-diabetic and
anti-cancer effects. These include gallic acid, tannic acid, catechin,
caffeic acid, p-coumaric, gentisic acid, chlorogenic acid and
epicatechin. Research shows these help to reduce
inflammation, balance hormones, regulate appetite, help prevent
obesity, prevent tumor growth and much more.
 8) http://www.nutrition-and-you.com/bitter-gourd.html

Bitter gourd (melon) nutrition facts

Bitter gourd (balsam pear/ bitter melon) is a young, tender, edible fruit-pod in the
Momordica genus of climbing vines. Although its bitter taste might turn some people away,
nonetheless, it truely can sweeten your health through virtue of its disease preventing and
health promoting phytochemical compounds.

Botanically, balsam pears belong to the Cucurbitaceae family, in the genus; Momordica,
and are member of the same family as squash, watermelon, cantaloupes, cucumber, etc,
belongs to.

Scientific name: Momordica charantia. Some of the related varieties are balsam pear,
cundeamor, la-kwa, etc.

Bitter melons (Momordica charantia). Oriental

variety. Note for the uneven pebble like
longitudinally arranged ridges. The ends are
round and blunt.

Bitter melon is one of traditional edible pod vegetables in many Asian countries. It is grown
widely as a field crop as well as backyard vegetable and, in fact, is among the most bitter
tasting of all culinary vegetables.

Bitter gourds hanging down

on a vine. This variety
 commonly found in Indian
subcontinent. Note for
pointed ends.

Bitter melon is a temperate/tropical plant probably originated in South-East Asia. Like in

other members of the Cucurbitaceae family, it too is a fast-growing, trailing or climbing vine
with thin stems and tendrils which require a trellis to support their climbing vines.

Bitter gourd pods are characterized by soft lengthwise ridges and uneven pebbly surface.
Depending upon the cultivar type, its immature pods can be light to dark green and have
oblong or oval shapes with a pointed tip at the blossom end. Internally, the flesh is white
with rough-edged seeds, somewhat similar to ridge gourd seeds in appearance. As the
fruits begin to mature, they gradually become hard, turn yellow or brown in color.

Health benefits of Bitter gourd

 Bitter melon is very low in calories, carrying just 17 calories per 100 g. Nevertheless,
its pods are rich sources of phytonutrients like dietary fiber, minerals, vitamins, and
anti-oxidants.
 Bitter melon notably contains phytonutrient, polypeptide-P, a plant insulin known to
lower blood sugar levels. Also, it composes hypoglycemic agent
called Charantin. Charantinincreases glucose uptake and glycogen synthesis inside
the cells of the liver, muscle, and fatty (adipose) tissue. Together, these compounds
may have been thought to be responsible for blood sugar levels reduction in the
treatment of type-2 diabetes.
 Fresh pods are an excellent source of folates, carrying about 72 µg/100g (18% of
RDA). Vitamin folate when taken by mothers during their early pregnancy time,
would help reduce the incidence of neural tube defects in the newborn babies.
 Fresh bitter melon is an excellent source of vitamin-C (100 grams of fresh pod
provides 84 mg or about 140% of RDI). Vitamin-C is one of the powerful natural
antioxidants which helps scavenge harmful free radicals from the human body.
 Further, it is an excellent source of health benefiting flavonoids such as β-carotene,
α-carotene, lutein, and zea-xanthin. It also contains a good amount of vitamin-A.
Together, these compounds help act as protective scavengers against oxygen-
derived free radicals and reactive oxygen species (ROS) that play a role in aging,
cancers and various disease processes.
 Bitter melon stimulates smooth digestion and peristalsis of food through the bowel
until it excreted from the body. Thus, it helps in relieving indigestion and constipation
problems.
 Further, it has small amounts of B-complex vitamins such as niacin (vitamin B-3),
pantothenic acid (vitamin B-5), pyridoxine (vitamin B-6) and minerals such as iron,
zinc, potassium, manganese and magnesium.
 Early laboratory tests suggest that certain phytochemical compounds in bitter melon
might be effective in the treatment of HIV infection.
Selection and storage

Fresh bitter melon pods can be available in the markets around the seasons. When you buy
them, look for fresh, bright pods that feature dark-green, without any cuts, or blemishes on
their surfaces. Choose young, tender immature fruit-pods. Immature fruits are least bitter
since this astringent level increases as the pods mature.

At home, fresh bitter gourd can be placed in a plastic zip pouch and stored in the vegetable
compartment of the refrigerator, where they stay fresh for up to a week.

Preparation and serving methods

Wash bitter gourds thoroughly in cold running water before cooking. Fresh pods, as well as
young leaves, can be used for cooking. Bitter taste can be reduced by marinating in salted
spice mixture and drying under sunlight. There are several local traditional methods to
reduce bitterness like boiling in salt water for 5-10 minutes and then discarding the water or
marinating in yogurt for about 30 minutes.

Although its pith and seeds discarded due to their higher alkaloid content, they can also be
enjoyed in some Asian regions without any reservations.

Here are some serving tips:

Goya chanpuru. A okinawan dish

prepared with bitter melon, tofu,
egg and onion.
Photo courtesy: jetalone

 In India, where it popularly known as karela, it is used in a variety of recipes either

stir-fried or stuffed with garam-masala, tomato,onions, green chilies, garlic and curry
leaves.
 Goya chanpuru, Okinawan stir-fry with bitter melon, onion, tofu, pork, and eggs, is a
special dish of the health-conscious island inhabitants.
  Known as ampalaya in the Philippines, it has been widely used in unique dishes
like Pinakbet Ilocano, prepared with shrimp paste and mixed with vegetables
like eggplant (aubergine) and okra.
 Dried and powdered whole bitter gourd has been used in the preparation of iced or
milk tea in some East Asian regions.
 Bitter gourd is also used in the pickling preparations.

Safety profile

Bitter gourd may contain alkaloid substances like quinine and morodicine, resins, and
saponin glycosides, which may be the cause of intolerance in some people. Their bitterness
and toxicity may be reduced somewhat by parboiling or soaking in salt water for up to 10
minutes. Toxicity symptoms may include excessive salivation, facial redness, dimness of
vision, stomach pain, nausea, vomiting, diarrhea, muscular weakness. (Medical disclaimer).
 9) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3174519/

Medicinal Chemistry of the Anti-Diabetic Effects of

Momordica Charantia: Active Constituents and
Modes of Actions
Abstract
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INTRODUCTION
Diabetes mellitus (DM) is one of the oldest known human disease currently affecting about 200
million people worldwide [1]. It is estimated that by 2025, more than 300 people globally will
have confirmed DM and other 50 million undiagnosed [2, 3]. This disease is the most common
metabolic disorder in human and it is characterized by hyperglycemia, due to relative or absolute
lack of insulin, the insensitivity of insulin or both [4, 5]. DM is classified into type 1 or insulin-
dependent DM (IDDM) or type 2 or non-insulin dependent DM (NIDDM) or T2DM [5, 6]. Type
1 DM represents about 5-10% of all cases of DM whereas T2DM accounts for 90-95% of
diabetes. Type 1 DM is characterized mainly by auto-immune-mediated destruction of beta cells
of the endocrine pancreas leading to reduced insulin secretion. This form of DM is prevalent in
young children [5, 7]. On the other hand, T2DM is characterized by insulin resistance and
relative insulin deficiency and it is due to sedentary life style, genetic disposition, obesity, human
behavior and environmental factors. Both forms of DM can lead to such long-term complications
as neuropathy, retinopathy, cardiomyopathy, nephropathy, exocrine gland insufficiency and
several other complications and eventually to death [5]. Type 1 DM is treated mainly with
insulin whereas T2DM is controlled by hypoglycemic drugs, regular exercise, general change in
life style habits and diet including some plant-based food. The plant kingdom is a good potential
source for the discovery of novel medicines to treat numerous diseases including DM. Currently,
about 400 plants incorporated more than 700 recipes and compounds which have been evaluated
extensively for the treatment of diabetes throughout the world [8-14]. In many parts of the world,
especially in poor countries, this may be the only available form of therapy for the treatment of
diabetic patients. One such plant is Momordica charantia (family name: Cucurbitaceae), nature’s
own cure for DM. M. charantia has been used extensively as an anti-viral, anti-bacterial agent
and more so to treat a number of infections and diseases [13]. These include DM, indigestion,
fever, skin disease, HIV, viral and bacterial infections, hypertension, reduced cholesterol and
inflammation, detoxification of the body, expelling worms from the body, balance certain
hormones in the body, enhances immunity, promotes milk flow, prevents different tumors and
several other reported medicinal benefits. This review is concerned specifically with the
medicinal chemistry of M. charantia and its extracts and active constituents to treat DM.
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PLANT-BASED ANTI-DIABETIC MEDICINE
Plant-based medicine has been used cost-effectively worldwide to treat DM. In fact, in many
parts of the world, especially poor countries, this may be the only form of therapy available to
treat diabetic patients. There are several reviews by different authors about anti-diabetic herbal
plants [9-11, 13, 15-17]. One review has listed more than 300 plant species which possess
hypoglycemic properties and classified them according to their biochemical names, country of
origin, parts used and nature of the active agent(s) [11]. From the current literature, it is evident
that M. charantia is the most widely used and popular anti-diabetic plant. Thus, this review will
concentrate mainly on M. charantia and its anti diabetic properties [13].
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CHARACTERISTICS OF M. CHARANTIA
Scientific name: Momordica charantia
Kingdom: Plantae
Division: Magnoliophyta
Family: Cucurbetaceae
Genus: Momordica
Species: Charantia
Duration: Annual
Some common names of M.charantia include bitter melon, papilla, bitter gourd, salsamino,
corrila or karela, hanzal, assorossie, ampalaya, nigauri or goya, pare, kho gua, sora, balsam
apple, pear or balsamina, and several other common names (see Taylor, 2002 [13] for extensive
review and technical data). M. charantia is cultivated in many damp and wet tropical countries
of the world including parts of South America and the Amazon basin including Brazil, Guyana
and the Caribbean, East Africa and Asia including India, China, Philippines, Pakistan, Nepal and
Sri Lanka. M. charantia is harvested both as food and as a medicine. It is a slender annual
climbing vine with long leaves and at reproductive stage it produces warty or wrinkled gourd
green fruits, resembling a squash or a cucumber. M. charantia is known for its very bitter taste
and this is found in the leaves, the fruits, the stems and other parts of the plant [17]. The bitter
taste is a distraction for eating the fruit but this is sometimes overshadowed by its beneficial
effect. People normally boil the green leaves and stem and drink the bitter content as tea. Some
people cook the fruit as a curry or with meat, while others eat it as a salad, fried it in oil or
liquidize it into a herbal juice. In some cases people neutralize the bitter taste with the addition of
a fruit (e.g. papaya) or a tropical juice such as mango or with a dash of salt. Commercially, the
plant is used to make a powder which is sold commercially as tea or as in capsule form.
Medicinally, the plant, its fruit and its powder extract possess a long history of use in the
treatment of numerous diseases including diabetes [9-11,13,15,17].
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EXTRACTS AND ACTIVE INGREDIENTS OF M. CHARANTIA
Generally, the public have used different parts of M. charantia including the leaves, the stem and
mainly the green fruits or seeds to treat diabetes. Table 11 shows the chemical structures of
momocharin (1) and momordicin (2) which is believed to possess insulin-like chemical structure
and properties. People eat the fruit raw, boil or cook the different parts or drink the pulp of the
fruit as a juice. Over the years several scientists have tried to isolate the various active ingredient
of M. charantia for commercial purpose.

Table 1

Chemical Structure of Momorcharin and Momorcidin

Fig. (11) shows a schematic diagram of the different stages of the isolation procedure for the
active ingredient(s) of M. charantia fruit employing water and organic solvents. Initially, the
fruits are chopped into small pieces and liquidized in deionized water. The green supernatant is
separated from the cellulose and subsequently, the water is extracted using a rota-evaporator.
The residue is dried in an oven and the green powder extract is used for experimentation or for
further extraction, purification and identification employing HPLC, affinity chromatography,
SDS-PAGE and NMR mass spectroscopic methods. Two medicinal compounds extracted
from M. charantia include, charantin, a steroidal saponin agent with insulin-like properties and
momordicin (2), an alkaloid responsible for the bitterness of the fruit [18]. In laboratory and
clinical in vitro and in vivo studies scientists and clinicians have employed different water,
ethanol and ether extracts as well as isolated biologically active phytochemicals including
glycosides (momordin and charantin), alkaloids (momordicin (2)), polypeptide-P, oils from the
seeds (linoleic, stearic and oleic acids), glycoproteins (alpha–momorcharin (1), beta-
momorcharin and lecitins) and others active compounds including protein MAP30 and vicine
(pyrimidine nuclease) to study their hypoglycemic properties using both human and animal
models [13]. Of these constituents, charantin, insulin-like peptides and alkaloids possess
hypoglycemic properties. They are more effective when they are combined and they produce
effects almost similar to the crude water soluble extract [13].

Fig. (1)
Schematic diagram showing the isolation procedures for the active ingredient(s) of M. charantia fruit
juice (redrawn from Day et al [19]). Further purification and identification procedures employ HPLC,
affinity chromatography, SDS-page and mass spectrometry. ...

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COMPOUNDS PRESENT IN M. CHARANTIA

Today around 228 different medicinal compounds have been isolated from the stems, leaves,
pericap, entire plant, aerial parts of the plant, endosperm, callus tissues, cotyledons and mainly
the seeds and unripe fruit in different laboratories in India, Japan, USA, Thailand, Egypt, China,
Taiwan, Australia, Nigeria, Pakistan, Brazil, Nepal, Philippines and Peru [19].
These different compounds have been classified into different chemical types. These includes
proteids, triterpenes, lipids, inorganic compounds, phenylpropanoids, carotenoids, steroids,
alkaloids, monoterpenes, alkene to C3, carbohydrates, benzanoids, alkanol C5 or more, other
unknown structure (e.g. kakara I-B, II-A and III-B) sterol and sesquiterpene. Of the 228 different
compounds, most of these fall under the groups of proteids and triterpenes [13].
The plant has many different chemical components, which help medicinally either alone or when
combined. One of the hypoglycemic components is a steroid saponin called momocharin
(charantin) (1) with insulin-like chemical effect. Charantin has a molecular weight of 9.7 kDa
and it is the belief that charantin is the active hypoglycaemic agent of M. charantia.
Table 22 shows similarities in the chemical structures of momocharin (1), momordicin (2) and
other commercially available hypoglycemic drugs (glibenclamide (3), gliclazide (4), Glipizide
(5), Metformin hydrochloride (6), Pioglitazone hydrochloride (7) used in the treatment of T2DM.
The hypoglycemic action of M. charantia and its isolated components may be due to its insulin-
like structure. Recently, two other anti-diabetic constituents were isolated from M. charantia and
both substances exerted hypoglycemic effects in mice. The cucurbitane triterpenoids were found
to have the structures, 5β, 19-epoxycucurbita-6, 5β, 19-epoxy-19, 25-dimethoxycucurbita-6 23-
(E)-dien-3β-ol and 3β-7β-25-trihydroxy-cucurbita-5, 23 (E)-dien-19-al. These two compounds
have more or less the same parent structure as α-β momocharin (1), and momordicin (2) [20].
More recently, momordicin 1 (2) was isolated from M. charantia and its chemical structure was
characterized as momordicin1 3, 7, 23,-Trihydroxycucurbitan-5,24-dien-19-al [20]. This
compound is more or less similar to the one identifies by Harinantenaina et al. [21].

Table 2
Chemical Structures of Momorcharin (1), Momordicine (2), Glibenclamide (3), Gliclazide (4), Glipizide (5),
Metformin Hydrochloride (6), Pioglitazone hydrochloride (7). Note similarities in structure momorcharin
and Momordicin and Hypoglycemic agents

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TRADITIONAL REMEDY
The literature has suggested that one-half of one cup of a standard leaves or whole herb
concoction, 1-2 times daily is adequate for a hypoglycemic effect. Alternatively, an amount of
one to two grams of the water extracted powder from either the leaf or fruit is adequate as a daily
dose. Many people liquidize two to three green fruits with water or with a tropical juice and
drink 10 to 20 ml twice per day prior to meal. The question which people often ask is: can they
take M. charantia with traditional commercial anti-diabetic drugs? The answer is to discuss the
matter with their General Practitioner first. There may be an element of drug interaction
between M. charantia and commercially available anti-diabetic glucose lowering drugs but
further experiments are required to determine the kind of interaction which may occur between a
commercially available hypoglycemic drug and M. charantia or its hypoglycaemic extract [22].
For people with T2DM there is no harm in using M. charantia alone, but combine this regimen
with regular physical exercise and modification of daily diet. Previous studies have described the
pharmacology, clinical efficacy, adverse effects, drug interactions and place in therapy of M.
charantia [22]. It is particularly noteworthy that M. charantia is an alternative herbal therapy
that has been used primarily to reduce blood glucose level for thousands of years in patients with
DM. Regarding adverse effects, some studies have reported hypoglycemic coma and convulsions
in children, reduced fertility in mice, a fetish-like syndrome, increase in gamma
glutamyltransferase and alkaline phosphatase levels in animals and some headaches [22].
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CLINICAL AND BASIC EXPERIMENTAL STUDIES

Over the past 50 years, both basic and clinical studies have been done to determine the effect
of M. charantia on the management of DM. Table 33 shows the effect of oral administration
of M. charantia on both animal and human type 2 models. Today the literature contains over 40
studies employing adult human subjects and another 100 have employed animal models. They
were administered with a hot water extract, concoction, the fruit, the fruit juice or the seeds [13].
Typically, of the twenty or more studies present in Table 33, only three have demonstrated no
beneficial effects, one on T2DM patient [16], one in rabbit [23] and the other in rat [24].
However, the other seventeen studies have successfully demonstrated that the whole plant,
ethanol extract, fruit juice, powder, concoction or seed can evoke hypoglycemic effects. The
reason for the three unsuccessful findings may be due to the fact that the authors employed high
doses of M. charantia. Previous studies have successfully demonstrated that M. charantia is
more beneficial as a hypoglycemic agent only at therapeutic doses. Either pharmacological or
high doses of M. charantia seem to exert inhibitory effects [17, 25]. To date, not much study
have been done on purified components of M. charantia in both human and animal models.
Table 3

Effects of Oral Administration of M. charantia on Diabetes Mellitus

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POSSIBLE MODES OF ACTION OF M. CHARANTIA AND ITS EXTRACT

M. charantia and its various extracts and components are believed to exert their hypoglycemic
effects via different physiological, pharmacological and biochemical modes [13, 15, 17, 33].
Table 44 lists some possible modes of the hypoglycemic actions of M. charantia and its various
extracts and compounds. Today over 140 different studies worldwide [13] have investigated anti-
hyperglycemic and hypoglycemic effects of the different extracts and ingredients of M.
charantia in both human and animal models. These include the fruit extracts with, either hot
water, ethanol, lyophilized, benzene, chloroform, acetone, fruit juice and powder. Of all the
different studies, about 120 have reported active and beneficial effects, whereas the remaining 20
have reported inactive or no beneficial effects. There are several reasons for these discrepancies
in the activity of M. charantia and its various extracts and isolated compounds. These may be
due to the duration (short time period) of the experiments, doses of the compounds (high doses
seem to evoke inhibitory or toxic effect) [32], the animal models and gender employed in the
studies, the method of application/administration, and in some cases the laboratories and
countries where the work was done and also the extracts administered. These discrepancies may
also be due to seasonal variations [13].

Table 4

Possible modes of hypoglycaemic actions of M. charantia

M. charantia, its extracts and isolated components are believed to exert their hypoglycaemic
effects via different physiological and biochemical processes. These include insulin secretagogue
like effect, stimulation of skeletal muscle and peripheral cell glucose utilization, inhibition of
intestinal glucose uptake, inhibition of hexokinase activity, suppression of key gluconeogenic
enzymes, stimulation of key enzymes, HMP pathway and preservation of pancreatic islet cells
and their functions (see Table 44 for relevant references).
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PRESERVATION OF PANCREATIC β CELLS AND INSULIN SECRETION

It was previously demonstrated by Jeewathayaparan et al. [25] that oral administration of
M. charantia could lead to the secretion of insulin from endocrine pancreatic beta cells. This
observation was further confirmed by Ahmed et al. [33, 39, 41] who investigated the effect of
daily oral administration of M. charantia fruit juice and the distribution of α, β and δ cells in the
pancreas of streptozotocin (STZ)-induced diabetic rats using immunohistochemical methods. In
these studies, they observed that M. charantia significantly increased the number of β cells
compared to untreated diabetic rats. However, the number of β cells was significantly less than
that obtained in normal and M. charantia-treated control rats. This may be due to the fact that the
study was only done for a period of 10 weeks and moreover, the STZ probably destroyed some
of the beta cell completely one week prior to the administration of the fruit juice to the animals.
From these studies, the authors concluded that M. charantia fruit juice may have a role in the
renewal of β cells in treated diabetic rats or alternatively, the juice may permit the recovery of
partially destroyed β cells [33, 39, 41]. Physiological experiments have also shown that M.
charantia can stimulate insulin secretion from the endocrine pancreas [42] and elicit glucose
uptake in the liver [43]. Current evidence therefore indicates that the recovery and subsequent
increase in the number of insulin producing cells followed by the release of insulin may be part
of the several pathways by which M. charantia exerts its hypoglycemic effects. In addition to the
properties mentioned above, M. charantia and its extracts may possess cell-like proliferation and
growth-like properties similar to that of insulin [5, 25]. Nevertheless, further experiment are
required, at least at the molecular level, to determine the precise mechanisms whereby M.
charantia can either repair damaged β cells or prevent their death.
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M. CHARANTIA AND GLUCOSE METABOLISM

Insulin plays a major biochemical role in stimulating the uptake of glucose by different cells of
the body for the production of energy [4, 5, 25]. Since M. charantia and its various extracts and
components have been reported to exert hypoglycemic effects, then it is important to understand
whether M. charantia may have a direct effect in inducing a reduction in blood glucose level
[13]. Previous studies have shown that both the aqueous and alcoholic extracts of the fruit of M.
charantia can inhibit the activities of fructose 1, 6-diphosphatase and glucose-6-phosphatase and
at the same time stimulating the action of glucose-6-phosphatase dehydrogenase [17, 19, 34, 36].
It was previously reported that M. charantia and its various extracts can stimulate peripheral cell
glucose uptake [17, 19, 25]. A number of studies have investigated the effect of the powder and
chloroform extract of M. charantia in comparison with insulin on glucose and amino acid
uptakes by skeletal L6 myotubes and Na+ and K+ glucose uptakes by jejunum brush border
membrane vesicles in both age-matched control and STZ-induced diabetic rats. The results show
that either the lyophilized fruit juice or chloroform extract at 5-10 μg ml-1 can stimulate 3H-
deoxyglucose and 14C–Me AIB (N-methyl-amino-α-isobutyric acid) uptakes by L6 myotubes.
These effects were similar in magnitude to the effects obtained with 100 nM insulin. Incubation
of either insulin or M. charantia juice in the presence of wortmannin (a phosphatidylinositol 3-
kinase inhibitor) resulted in a marked inhibition of 3H-deoxyglucose uptake by L-6 myotubes
[25, 44]. Together, the results have clearly demonstrated that M. charantia contains insulin like
properties, similar to one phytochemical component of M. charantia called V-insulin [13].
In addition to its insulin-like effects on skeletal muscle cells, daily oral intake of M.
charantia fruit juice over a period of 10 weeks significantly reduced the amount of Na+ and K+-
dependent 14C-D-glucose absorbed by rat jejunum brush border membrane vesicle compared to
vesicles obtained from STZ-induced diabetic rats [33,41]. Taken together, these results clearly
demonstrated that M. charantia and its extracts can directly regulate blood glucose via two
mechanisms. Firstly, it can regulate how much glucose is absorbed by the gut into the blood
following a meal and secondly, it can stimulate glucose uptake into skeletal muscle cells just like
insulin. Moreover, it seems to exert its effect via the same intracellular signaling pathways as
insulin in regulating glucose metabolism in the body [44].
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ANTI NEUROPATHIC EFFECT OF M. CHARANTIA FRUIT JUICE

Human diabetic neuropathy is both cumbersome and complicated and it may result in severe
disability [5,6]. In addition, treatment of diabetic neuropathy is very expensive. The most cost
effective way is to either prevent or delay the onset of this, long-term diabetic complication. The
influence of M. charantia fruit extract and insulin on the ultra-structural abnormalities of
myelinated fibers in experimental diabetes in rats was investigated in previous studies
[33, 37, 40].
The results have shown that the mean cross-sectional myelinated fibre area, axonal area and
myelin area including the mean maximum myelinated fibres area were significantly less in
untreated diabetic rats when compared with age-matched controls. In the M. charantia treated
diabetic animals, myelinated fibre area and myelin area were significantly greater than untreated
diabetics and not significantly different from age-matched controls. The mean value for the
maximum fibre area was also significantly greater than untreated diabetics and was not
significantly different from age-matched controls. The axon to fibre ratio (‘g’ ratio) did not differ
between any of the experimental groups. It was concluded that the administration of M.
charantia fruit juice not only reduced blood glucose level but also corrected the structural
abnormalities of peripheral nerves in experimental diabetes. These results have strongly
indicated that M. charantia possesses growth factor-like properties just like insulin
[5, 31, 37, 39].
To date, M. charantia has been extensively studies worldwide for its medicinal properties to treat
a number of diseases [38]. It is described as a versatile plant worthy of treating almost any
disease inflicted on mankind. This may be due to the fact the plant possesses over 225 different
medicinal constituents [13]. These different compounds may act either separately or together to
exert their medicinal effects. In relation to diabetes [46], only charantin, insulin-like peptide and
alkaloid-like extracts possess hypoglycemic properties similar to the plant itself or its crude
extracts. These different compounds seem to exert their beneficial effects via several
mechanisms to control and treat diabetes mellitus.